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Stress urinary incontinence
Leaking with a cough, a sneeze, a laugh or a run. Common after childbirth and around the menopause, and not a normal part of ageing.
This is one of the conditions women are most likely to accept as inevitable, and one of the most reliably treatable. A large proportion of affected women never raise it with a doctor at all — usually because they assume nothing can be done, or because it feels too trivial to bring up.
Assessment
A history that establishes when the leaking happens and how much it affects you, an examination including the pelvic floor, and a urine test to exclude infection. Where the pattern suggests urgency rather than stress incontinence — or a mixture of the two — that changes the treatment, so it is worth distinguishing carefully.
Treatment, in order
- Pelvic floor physiotherapy — first line, non-invasive, and effective for a great many women when done properly and given enough time
- Lifestyle measures — weight, caffeine, fluid timing and managing constipation, all of which genuinely shift the picture
- Office-based options — including bulking agents for mild to moderate cases
- Mid-urethral sling surgery — where conservative treatment has not been enough
Most women start with physiotherapy, and a good number need nothing further.
Risks and what to expect
Mid-urethral sling surgery uses synthetic mesh and carries recognised risks including pain, mesh exposure or erosion, difficulty emptying the bladder, new urinary urgency, recurrence of leaking, and the possibility of further surgery. Bulking agents are less invasive but wear off and often need repeating. These trade-offs are discussed in full before any decision.
Every procedure carries risk, and the risks that matter most depend on you — your history, your anatomy and your general health. They will be explained to you in full, in writing, before you are asked to consent to anything.
Any recovery times given here are typical rather than guaranteed, and outcomes vary from one person to another.
Every case is different, and what is right for one woman is not right for another. The purpose of a first appointment is to work out which applies to you. Arrange a consultation.
The information on this site reflects current international best practice and peer-reviewed literature, together with Dr Sharma’s own clinical experience. It is general information, not advice for your own situation, and is not a substitute for a consultation.
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